Canadian journal of respiratory therapy : CJRT = Revue canadienne de la thérapie respiratoire : RCTR
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Long-term lung transplant success is limited by bronchiolitis obliterans syndrome (BOS), a form of chronic allograft rejection that manifests in the majority of patients by five years post-transplant. Frequent monitoring of pulmonary function measurements through the use of daily home spirometry may have the capability to detect the onset of BOS sooner than standard pulmonary function testing. Early detection of BOS would confer a treatment advantage that may improve survival outcomes for lung transplant recipients. ⋯ Daily home spirometry has been shown to lead to earlier detection and staging of BOS when compared with standard pulmonary function testing. Although FEV1 has been shown to be the most sensitive and reliable marker of BOS onset, the impact of earlier staging via home spirometry on survival has not been reliably determined.
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The present outbreak of Ebola has health care professionals seeking guidance on isolation precautions for routine care and aerosol-generating procedures (AGPs). The most recent guidelines state that during AGPs, health care professionals should wear respiratory protection at least as protective as a National Institute for Occupational Safety and Health-certified fit tested N95 filtering face piece respirator or higher; for example, a powered air-purifying respirator (PAPR). ⋯ Training programs on proper donning and doffing of personal protective equipment and quality control systems need to be in place. Respiratory therapists are frontline during AGPs and need to be active in the decision making of the type of equipment chosen to protect them.